活血柔肝法改善慢性肝炎肝纤维化的效果  

Effects of promoting blood circulation on hepatic fibrosis in patients with chronic hepatitis

作　　者：李锋[1] 周新民[2] 行利[1] 张珊红[3] 姚菊峰[1] 

机构地区：[1]解放军第四军医大学西京医院中医科,陕西省西安市710033 [2]解放军第四军医大学西京医院消化内科,陕西省西安市710033 [3]解放军第四军医大学西京医院老年病科,陕西省西安市710033

出　　处：《中国临床康复》2006年第23期96-98,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察灵丹顺肝汤治疗慢性肝炎肝纤维化的临床疗效。方法:选择2001-01/2003-12解放军第四军医大学西京医院门诊及住院、符合《病毒性肝炎的诊断标准》的患者65例。①按治疗先后顺序分为灵丹顺肝汤治疗组(治疗组)34例、常规治疗组(对照组)31例。对照组给予常规治疗:云芝胞内糖肽,2粒/次,3次/d;或50g/L葡萄糖注射液250mL加甘利欣150mg静脉点滴,1次/d;维生素C、肌苷片与饮食调理。②治疗组在常规治疗基础上,加服灵丹顺肝汤(灵芝、丹参、苦参等),50mL/次、3次/d。疗程共3个月。②观察治疗前后肝纤维化4项(透明质酸酶、Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白),肝功能(丙氨酸氨基转移酶、天门冬氨酸转氨酶、总胆红素);B超检测门静脉主干内径、脾脏厚度;临床症状变化。③参照《中药新药临床研究指导原则·黄疸》标准进行疗效判定,分为显效,有效,无效。结果:①治疗组患者治疗前后血清透明质酸酶、Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白水平明显降低,门静脉主干内径、脾脏厚度亦见缩小,治疗组显效率提高、临床症状明显缓解,与对照组比较差异均有显著性(P<0.05)。②两组患者治疗前后肝功能均明显改善,但治疗组总胆红素降低与对照组比较差异有显著性[(13.30±6.01),(19.13±9.61)μmol/L,P<0.05)。③治疗组显效17例,有效13例,无效4例,总有效率88.3%;对照组显效11例,有效14例,无效6例,总有效率80.6%。④治疗组用药后无明显不良反应。结论:灵丹顺肝汤具有抗肝纤维化作用,整体调节中医脏腑(肝脾)功能,明显缓解全身乏力、腹胀、纳差症状,临床疗效肯定。AIM： To observe the clinical effect of lingdan shungan decoction in the treatment of hepatic fibrosis in patients with chronic hepatitis. METHODS： A total of 65 inpatients, outpatients and those being in accordance with the diagnostic criteria of virus hepatitis （VH） were selected from Xijing Hospital of the Fourth Military Medical University of Chinese PEA between January 2001 and December 2003.①All subjects were divided into lingdan shungan decoction group （treatment group, n=34） and routine treatment group （control group, n=31） according to the sequence of treatment. Patients in the control group were given routine treatment： polystictus glycopeptide capsule three times a day and 2 capsules once or 50 g/L glucose injection 250 mL plus 150 rag of diammonium glycyrrhizinate by venous dropping once a day. Vitamin C and carnine were adoptedand the drink and food patients were regulated. ②Patients in the treatment group were given lingdan shungan decoction （mythic fungus, danshen root and lightyellow sophora root etc.） based on routine therapy three times a day and 50 mL once for totally 3 months. ③Four items of hepatic fibrosis[hyaluronidase （HA）, type Ⅲ pre-collagen （PCⅢ）,type Ⅳ collagen, laminin（LN）], hepatic function [alanine aminotransferase （AAT）, aspartic transaminase, total bilirubin] before and after treatment were observed. B ultrasound was used to determine the internal diameter of main portal vein, thicknessof spleen and the changes of clinical symptoms. ④The curative effects were judged according to the guidance principle of the clinic research of new traditional Chinese Medicine, including effective, valid and invalid. RESULTS： ①The levels of HA, PCⅢ, type Ⅳ collagen and LN in patients of treatment group before and after the treatment were obviously decreased, and the internal diameter of main portal vein and spleen thickness were reduced significantly.The effective rate of the treatment group wasenhanced, and the clinical symptoms were re

关 键 词：肝炎 慢性 肝硬化 中药疗法 

分 类 号：R575.1[医药卫生—消化系统]